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Clinical vignette
Published online: 2022-11-28
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Obesity — a still underestimated risk factor during antenatal corticosteroids therapy

Aleksandra Stupak1, Tomasz Geca1, Arkadiusz Krzyzanowski1, Maciej Kwiatek1, Iwona Slowik-Kwiatkowska2, Anna Kwasniewska1
Affiliations
  1. Chair and Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, Poland
  2. Chair and Department of Internal Diseases, Medical University of Lublin, Poland

open access

Ahead of Print
CLINICAL VIGNETTES
Published online: 2022-11-28

Abstract

Pregnant obese patients are at a greater risk of developing gestational diabetes (GDM). We present a case of an obese patient who developed GDM G2 and periventricular leukomalacia in the neonate after antenatal corticosteroids (ACS) treatment. We suggest that routine blood glucose monitoring should be considered during a course of prenatal steroid therapy in all patients in a higher risk group for glucose intolerance. In cases of hyperglycemia, intensive insulin therapy should be advised. More research and new recommendations are needed on antenatal glucocorticoids (GCS), obesity, and GDM.

Abstract

Pregnant obese patients are at a greater risk of developing gestational diabetes (GDM). We present a case of an obese patient who developed GDM G2 and periventricular leukomalacia in the neonate after antenatal corticosteroids (ACS) treatment. We suggest that routine blood glucose monitoring should be considered during a course of prenatal steroid therapy in all patients in a higher risk group for glucose intolerance. In cases of hyperglycemia, intensive insulin therapy should be advised. More research and new recommendations are needed on antenatal glucocorticoids (GCS), obesity, and GDM.

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Keywords

gestational diabetes mellitus; corticosteroids; obesity; pregnancy; insulin therapy

About this article
Title

Obesity — a still underestimated risk factor during antenatal corticosteroids therapy

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Clinical vignette

Published online

2022-11-28

Page views

466

Article views/downloads

299

DOI

10.5603/GP.a2022.0132

Pubmed

36448344

Keywords

gestational diabetes mellitus
corticosteroids
obesity
pregnancy
insulin therapy

Authors

Aleksandra Stupak
Tomasz Geca
Arkadiusz Krzyzanowski
Maciej Kwiatek
Iwona Slowik-Kwiatkowska
Anna Kwasniewska

References (7)
  1. Bomba-Opoń DA, Godek B, Czekaj L, et al. Hyperglycemia in pregnancy - prevalence and perinatal outcomes. A retrospective multicenter cohort study in Poland. Ginekol Pol. 2022 [Epub ahead of print].
  2. Ornoy A, Becker M, Weinstein-Fudim L, et al. Diabetes during pregnancy: a maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. A clinical review. Int J Mol Sci. 2021; 22(6).
  3. Rahmi RM, de Oliveira P, Selistre L, et al. Continuous glucose monitoring in obese pregnant women with no hyperglycemia on glucose tolerance test. PLoS One. 2021; 16(6): e0253047.
  4. Star J, Hogan J, Sosa ME, et al. Glucocorticoid-associated maternal hyperglycemia: a randomized trial of insulin prophylaxis. J Matern Fetal Med. 2000; 9(5): 273–277, doi: 10.1002/1520-6661(200009/10)9:5<273::AID-MFM3>3.0.CO;2-N.
  5. Herzog M, Cerar LK, Sršen TP, et al. Impact of risk factors other than prematurity on periventricular leukomalacia. A population-based matched case control study. Eur J Obstet Gynecol Reprod Biol. 2015; 187: 57–59.
  6. Dalfrà MG, Burlina S, Sartore G, et al. Ketoacidosis in diabetic pregnancy. J Matern Fetal Neonatal Med. 2016; 29(17): 2889–2895.
  7. Myszkowski B, Stawska A, Glogiewicz M, et al. Influence of gestational diabetes in twin pregnancy on the condition of newborns and early neonatal complications. Ginekol Pol. 2022 [Epub ahead of print].

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